This question stems from my Eclipse Phase campaign, but applies to any high-tech setting. While the setting books describe a wealth of technology, there are plenty of tools that are not listed. That's fine, of course. Imagine trying to list all of the technology common in our day to day existence.

What I find challenging as a GM is dealing with those situations when a player asks if their character can have an item that is not on any gear lists, but makes sense for the setting. For example, if the list shows three types of portable medkits but doesn't show a similar kit for synthmorphs, it's not unreasonable for such a kit to exist in the game world. I tend to run games in a sandbox fashion as much as possible, so ordinarily I agree to the request and we craft stats for the item on the spot.

There are, however, moments when gear generated in such a fashion gives the PCs such an edge that they overcome obstacles with ease. As a GM, how do you give PCs latitude in a high-tech world without letting them easily slice through challenges you've set up for them?

6 Answers
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I figured I'd try to answer the part of the question that most of the other answers haven't really touched on yet, namely "How do I decide whether a particular piece of tech would be too disruptive?"

One way to approach this question is to ask yourself, "How could the players achieve the same effect using things that are listed in the books?" If all the effects of the tech you're considering could already be achieved by other means (even if they might not be quite as practical), it's unlikely to completely break the setting. It might still have an effect on game balance, of course, but you'll at least have some kind of upper bound on how much difference the new tech could make by comparing the difference between the new and the established ways of doing things.

Taking your portable medkit for synthmorphs as an example, you should ask yourself "How else could the players heal a sick or injured synthmorph?" Maybe they can take him/her/it to a hospital; a hospital isn't portable, but it means that all the players are saving by using the medkit is the time and effort to travel to the nearest one. That could still make a big difference, depending on just how far the closest hospital is, but at least it gives you some idea of how big the difference could be. Or maybe your setting has magic as well as tech, and there's already a healing spell that works on synthmorphs, in which case having the medkit just means the players don't necessarily need to bring a mage with healing skills along.

Of course, when using this method, you should generally try to keep the effects of the new tech fairly conservative compared to what already exists in the game. For example, the medkit probably shouldn't be able to fix anything the hospital couldn't. In fact, its abilities should most likely be strictly inferior by a considerable margin, both for the sake of realism and to offset its convenience. Also, since the players can't really keep running to a hospital every few minutes, there should probably also be a limit on how often the medkit can be used, and/or on how long it takes to do its job. And, of course, if the setting clearly implies that something is generally lethal or disabling to synthmorphs, well, the medkit probably shouldn't be able to fix that.

This conveniently segues into another question you can ask yourself, namely "What effects would the existence of this tech have on established (or planned) elements of the setting?" For instance, try to think of any events in the backstory of the setting where having this tech might've made a difference. If you find yourself thinking "Well, those guys sure wouldn't have lost that battle if they'd had these medkits," and you can't think of any good reason why they shouldn't have had them if they existed, that could be an indication that adding that tech to the setting might at least disrupt the consistency of the backstory, if nothing else.

Also, think not just about what your players could or would do with the tech, but also about what their enemies (and other NPCs) could do with it. You're going to need to think about that sooner or later anyway, unless there's some good reason why only the players should have it, so you might as well think about it before you decide that it really exists.

If you have a suitably devious mind, you should also ask yourself "How could I abuse this tech if I wanted to?" Obviously, that means not restricting yourself to how you or the players think the tech should be used, but just looking at the stats as you've written them and thinking "OK, if I wanted to min-max and exploit the hell out of this thing, and had enough resources to pull it off, what could I do?" OK, so one portable medkit seems pretty harmless; what if you had a hundred of them, and combined them with all the most exploity features already in the game, what could you do then?

If you're not feeling so devious, a simpler alternative can be to just ask your players up front what they want to do with the tech. Then, if it sounds reasonable to you, write the specs so that it does that and nothing (too much) more. One advantage of this method is that you can harness your players' creativity in finding ways in which the new tech could be troublesome. (In particular, the kind of people who like to come up with exploits for game mechanics are also typically happy to point out those exploits before the mechanics are made part of the game, just as long as they get the chance to demonstrate their cleverness.) It also, in effect, binds the players into an unspoken promise not to step significantly beyond the limits they themselves set, or at least gives you and excuse to step in and say "Hey, wait a minute, that wasn't the way it was supposed to work!" if they do.

Finally, if you're not sure, don't be afraid of saying "OK, let's try it and see." Playtesting is an essential part of balancing the rules of any game, and there's no reason why you can't do that with your house rules too. Just tell your players that they can have the tech for one session to begin with, but that, if it unbalances the game too much, it's going to go away (or be redesigned) for the next session. In extreme cases, you can even tell your players "OK, that was just way too broken, let's just start over and replay the session without it." As long as the players knew in advance that this was going to be a test session, and as long as they can agree that the test didn't work out the way it was supposed to, they'll understand that.

"ask your players up front what they want to do with the tech" this might not work with some problem-players, as pointed outlined in this question. (granted: if you have such a problem-player, you have a bigger problem anyway)
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LohorisMay 11 '14 at 16:27

Think of all the things the TSA won't let you bring on planes. Now imagine a higher-tech world where dangerous things are even easier to make out of seemingly-innocuous items. Why can you have a medkit with A but not B? Because someone figured out how to use B to weaponize ebola, or cause apparently natural heart attacks from 50 feet away, or...

Shotgun Availability

In Vernor Vinge's novel Rainbow's End, one of the main characters is an older gentleman who's been lucky enough that all the problems he has from old age are things that cures have been found for. If he'd had some other kind of cancer, or a different variant of Alzheimer's, etc...

"You're a very lucky guy, do you know that?"

"How do you mean?"

"You picked all the right diseases! Modern medicine is kind of like a minefield made in heaven. ...all your major infirmities are things we have slam-dunk fixes for."

Just because something seems like it should be trivial in the future doesn't mean it actually is. It may have turned out to stubbornly resist research efforts (fusion power is always ten years away), or it just never got the funding, or the right genius never looked at that particular niche case. Think about what people in the 50s thought we'd have in the future (flying cars) versus what we actually have (iPhones).

Oh, You USED to Be Able to Get Those, Ten Years Ago, for About Six Months

Maybe it was perfectly easy to get 10 years ago. But, you know, the market for them just wasn't there, they weren't worth the cost of making, and nobody manufactures them any more. Or the first versions turned out to have some really nasty side effects, and ever since That One Incident the entire industry has been a dirty word for most people; reputable companies won't even touch that field if they value their stock price, so if you can get it it's hard to find, overpriced, unreliable at best, and everyone looks at you funny when you try to buy it.

Is That Firewire Or USB?

It may be easy to come by, but that doesn't mean it's compatible with the rest of the PCs' equipment, or with whatever else they need it to work with. Not every setting is Halo. Sure, one standard or the other will win out in five years or so, but that doesn't help the party now.

We're Working on a Hotfix for That Right Now

If it's something that will only break your plot right now, but won't be an issue by the next scene or two, then maybe it's just not working right now. The manufacturers just pushed out a new patch that apparently broke that functionality. Oops. They know it's inconveniencing everyone, the engineers are all working on it frantically, they expect to have it fixed in the next 24 hours or so, and they're really really sorry.

+1 for the hotfix! That made me LOL, my players are gonna hate you for giving me that idea!
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LeezardJan 10 '13 at 1:21

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+1 for terrorist. It doesn't even need to be that bad - just illegal, possibly due to strong corporations. For example, the Cap'n Crunch whistle that accidentally made the exact right tone to give free long-distance and international calling.
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IzkataJan 10 '13 at 13:12

I have to say that Hotfix is not fun. It should be your last resort because it is and will feel like a Deus Ex Machina cop out. Generally it is best not to surprise your players with something like that. Give them a challenge to overcome, not a surprise that leaves them with no option other than to deal with the down-side. Give them every possible chance to figure out a way to avoid the issue. Caveat: if the hotfix happens during down time, it could be a good story hook. But if they prepare and are hit with it at the last second, they'll probably not stay in your game much longer.
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DampeS8NJan 10 '13 at 14:16

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@DampeS8N The "hotfix" idea is absolutely perfect if you're playing Paranoia. Depends on the system, setting and tone I guess.
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TacroyJan 10 '13 at 17:13

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@DampeS8N The hotfix is just another tool for the toolbox. Used in an appropriate fashion it will be fine (and fun).
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LeezardJan 10 '13 at 17:32

Size

Yes, the technology exists. It's the size of a room. If you can find a lab that has one, you may be able to rent it by the hour. You must provide 100 points of ID to do so (limiting criminal or anonymous activity.)

Limited Ammunition

D&D often provide magical weapons in the form of wands with limited charges, such as a Wand of Fireball (4 charges). The same can apply to any sci-fi equipment.

Due to the unique physiology of synthmorphs, each synthmorph medkit is only good for a single use.

Special weapons you've collected use ammunition that's unheard of and unobtainable, bar raiding the original owner's armoury. You only have what's remaining in the gun. There's always some kind of sci-fi jargon available that will explain why you can't manufacture or recharge ammunition.

Maintenance Costs

Consumable supplies have to be restocked after every x uses.
Internet roaming charges are outrageous in this region.
Annual licensing fees ensure are required to keep up to maintain compatibility.
The engine breaks down after every second use.

Stock Levels

Whenever my players ask to buy something, I select an appropriate availability rating for the locality. The player makes a Streetwise check versus that availability to locate a dealer (legit or shady) who will is selling the item. If the test fails significantly or critically, they are either sold a dud, or get the police/enemies attention in the process.

Not as expected

The instructions are written in X'bl'iese.
Your tool set has one tool a little too big/powerful, and another tool a little too small/under-powered.
It only comes in fluorescent pink, not good for stealth purposes.
It uses a non-standard socket/port.
It's only available in a package, costing 10-times as much as the tool alone and offering little extra value.
You bought a cheap knock-off. You suffer a penalty when using it due to its poor design.

Carrying Capacity

Sometimes a player wants to use a common item that isn't specifically marked on their character sheet. They say "It'd make sense that I'd be carrying a thing with me. I pull out my thing and use it."

Sometimes I allow it. Sometimes I reply "Did character name have the forethough to pack a thing? Make a Smarts/Intelligence check."

For this reason, one of my characters always carried her handbag which invariable contains every odd and seemingly useless item she'd ever need.

Congratulations

Okay, you were outsmarted by the PCs. Congratulations to them. It happens to every GM. Give them a reward such as a small amount of loot or a temporary bonus, after all, you should promote creative thinking.

Then pull a previously unplanned obstacle from your hidden bag of tricks. It shouldn't be any more challenging than the last one, so long as they use their newly acquired bonus. If you do it right, they players will enjoy beating another challenge rather than see you as a bad-sport GM.

Oblivious Sage's answer is fantastic, but except for his very last bullet they are all reasons to deny a request for equipment, they don't do much to help if you already handed the players a piece of equipment and implied it was reasonably easy to get in the world.

So let me add some thoughts on how to handle it if the players already have it.

The direct approach: Talk to them and "it doesn't work THAT well."

In an RPG nothing is set in stone. If something is working too well, you can tweak it, even retroactively tweak it, to make it less good. There is nothing wrong with just saying up front "That was an experiment, it worked too well, so we're going to limit it."

More subtle: It has side effects.

Actually, this one can be a fun one to work in deliberately even on something that isn't overpowered. You mentioned medkits for a specific thing, maybe it works exactly as advertised but comes with rare side effects, perhaps even side effects that the manufacturer didn't know about yet because they only affect 1 out of 500, but the PC happens to be one of them. For a medkit it could be all sorts of things including addiction, medical problems, hallucinations, or even more subtle mental issues that can lead off into their own side plots.

Similar: It has bugs

Similar to the side effects, but not quite the same it might have bugs. Depending on how you feel about the device in question, those bugs might make it all but unusable so you can get rid of it. Or it might work as advertised 99% of the time, but fail in a spectacular, catastrophic way every so often. That would make the players think twice about using it too often but still let them have it for those dire situations.

Hard but fun: Adjust the world.

So, the PC got some fun new piece of tech that is helping them too much. But lots of pieces of technology are in an arms-race (when talking about weapons, sometimes literally). If they got the cure for a problem caused by a virus, the virus might mutate to be even worse. If they got some piece of computer gear that lets them cut right through the opponents counter measures, the counter-measures get better. If they got some great weapon, the enemy got better armor or a similar weapon, or both. If they got a great new piece of cyberware, then so does the opposition, or worse it turns out that that particular piece of cyberware can be hacked.

Of course, the new countermeasures might not be rolled out all at once, so they still get to feel overpowered with their new toy occassionally, but not all the time.

I had thought of adjusting the game world, but I'm a bit nervous about that spiraling out of my control. The side effects/bugs angle is great.
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Erik SchmidtJan 10 '13 at 3:48

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@ErikSchmidt Adjusting the game world can spiral out of control fast, it is hard. But it is also realistic since it happens in real life constantly. And it is a way of limiting the impact of an item without actually "nerfing" it directly.
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TimothyAWisemanJan 10 '13 at 17:44

One thing no-one else has explained thoroughly yet, although Zoot's answer touches on it, is how to take items away from players once they've been tried out and proven to be overpowered.

Talk to players

This has been mentioned, but I'm including it for the sake of completeness. Just tell them that you've made a mistake and either retcon the item, remove it from the game world, or ask the players to voluntarily give it up. Tell them it's to improve the enjoyment of the game, and if they don't want to give it up, you can (if necessary) use Rule 0 - although this should be a last resort, it may be necessary if you are playing with munchkins.

The world adapts

If a modern nation were to suddenly unveil an anti-nuke shield, many other countries would concentrate a lot of resources on finding out how to make their own and/or pierce the other country's shields. This would be the same in practically any setting, magical, modern or sci-fi. When one piece of technology improves, either the defenses against it improve or everyone else buys one. If the PCs can buy a cannon that pierces all conventional armour, eventually everyone else will have one too, or they'll develop a way to stop it - in which case the PCs will also need to buy the new armour. Basically, my point is that often new technology will eventually settle into a new status quo. If you make it fit the setting, this can be after anything from 5 minutes when the PCs figure out how to exploit it, to a few sessions later after introducing it when you've decided it doesn't really fit the setting.

It works, up to a point...

Basically, if the gear is a McGuffin or otherwise necessary for certain in-game purposes, introduce a series of exceptions to stop it being overpowered outside of certain situations it is designed for. If the new explosives that have the power of 5 tons of dynamite, made to enter a new dungeon, start being used in combat to destroy enemy vehicles, it can be given an irregular fuse - it can't be timed well enough to hit moving targets. A medkit that is meant to stop synthmorphs from having to go to the hospital a lot might need specially-cleaned gear that simply can't be sterilised outside of a large hospital or medical lab. This makes it useful for essentially carrying healing doses, but now it can't be used to heal more than once without being 'recharged'.

The unshielded air vent

Eventually, some enemies find out the hidden weakness (preferably suitably sci-fi so players can't argue) of this piece of gear. There's a few things that make players want to get rid of gear, such as remote exploitation of weaponry (after your own super-ultra-gun shoots you, normal weapons start looking good), immunities (the BBEG has a series of magnetic systems that stop the fuse from lighting so your explosives are useless), or not being able to recharge it again (the special crystals needed for sterilising the medkits have all been stolen by the villain(s)) and disabling it, or even reversing its effects (a medkit might now cause damage, as the dose of scifiingredient longwordicus is now too high).

I remember playing Rifts many years back, and some of the source books had some very powerful items. One of the GM methods of dealing with a weapon that was too powerful for the group would be for extremely powerful in-game repo men/creatures/robots to attack the group with the sole purpose of disabling the group and retrieving the repossessed tech/weapon. The GM could then make it a plot point to steal the item back at a more appropriate point in the game if the player really wanted to use the weapon/tech.

This sounds like a last-ditch option, because it would infuriate me as a player to have a weapon taken away in this manner.